Blockade of knee, shoulder, hip joint with diprospan

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Content

  • 1Diprospan for joints
    • 1.1What is Diprospan
    • 1.2Indications for use
    • 1.3Dosing and Administration
    • 1.4Side effects and contraindications
    • 1.5Application during pregnancy and lactation
    • 1.6Overdose
    • 1.7Terms of sale
    • 1.8Price and analogy
    • 1.9Reviews about nyxes Diprospan
  • 2What is the blockade of the knee joint (shoulder, elbow, hip): treatment with injections of drugs (Diprospan)
    • 2.1How does the treatment work?
    • 2.2Preparations for blockade
    • 2.3Indications for the procedure
    • 2.4When blockade is prohibited
    • 2.5How does blockade occur?
  • 3Knee joint: blockade with diprospan, side effects of the substance
    • 3.1Blockade of knee joint with diprospan
    • 3.2Diprospan Preparation
    • 3.3Application of the drug
    • 3.4Indications for blockade
    • 3.5Contraindications for blockade
    • 3.6Conducting the procedure of blockade
    • 3.7Complications after surgery
    • 3.8Forecast
  • 4Blockade of knee and shoulder joints by diprospan
    • 4.1The main advantages
    • 4.2Indications for blockade
    • 4.3Contraindications
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    • 4.4Preparing for the procedure
    • 4.5Technique of execution
    • 4.6Dosage of the drug
    • 4.7Blockade of the knee joint
    • 4.8Blockade of the shoulder joint
    • 4.9After the blockade
    • 4.10Forecast
  • 5Are Diprospans injected into the joint dangerous?
    • 5.1Indications for use
    • 5.2Contraindications
    • 5.3Consequences and side effects
    • 5.4Instructions for use
    • 5.5"Blockade of pain in the neck by Diprospan"

Diprospan for joints

Diprospan is a glucocorticoid drug for parenteral administration, which represents a unique drug that combines the form of prolonged action and high-speed substance. Thus, injections, Diprospan not only contribute to the rapid elimination of pathological symptoms, but also provide a long-term therapeutic effect.

What is Diprospan

The drug is part of the group of glucocorticoid agents.

The active substance of injections of diprospan is betamethasone disodium phosphate, which ensures the efficiency therapeutic effect, and betamethasone dipropionate, which contributes to the prolongation of the drug over several weeks.

The drug is produced in clear glass ampoules in the form of a suspension for injection of 1 ml. There are 2 versions of the package: 1 and 5 ampoules. The kit includes disposable syringes with 2 needles for the collection of medication from the ampoule and for administration.

Diprospan as a glucocorticoid drug has a powerful anti-inflammatory, analgesic, anti-allergic effect. Therefore, the spectrum of its application is quite wide, but in most cases Diprospan is used for joints and spine.

Diprospan is available as an injection suspension

Indications for use

According to the instructions for use, Diprospan nipples can be used in the following cases:

  • inflammatory diseases of the structures of the musculoskeletal system (myositis, tenosynovitis, synovitis, bursitis);
  • pain syndrome with arthrosis of the knee joint and other joints of the body (blockade of the knee joint);
  • Diprospan in rheumatoid arthritis can effectively eliminate pain;
  • injections help to eliminate joint pain in joints with gout and psoriasis;
  • with osteochondrosis of the spine with persistent pain syndrome;
  • conservative treatment of hygromas of any localization;
  • humerus periarthritis (blockade of the shoulder joint);
  • pain in the lumbar region, thoracic spine and neck;
  • pain syndrome after traumatic injuries;
  • with osteochondrosis of any segment of the spine and its consequences (hernia of the spine);
  • allergic reactions (insect bites, hay fever, hay fever, allergic rhinitis, hives, Quincke's edema);
  • shock states of different genesis;
  • an attack of bronchial asthma;
  • various skin diseases;
  • systemic connective tissue diseases;
  • treatment of leukemia;
  • adrenal insufficiency;
  • liver disease and liver failure.

Blockade of the spine with Diprospan perfectly eliminates pain

Dosing and Administration

Diprospan can be used for:

  • intramuscular injection;
  • injections into the joint;
  • introduction into soft tissues near the joint (blockade);
  • introduction into the synovial burs;
  • intradermal application.

The drug is not intended for intravenous and subcutaneous administration. Dosing regimen and duration of therapy are determined in each case individually, depending on the disease and its severity.

For systemic therapy (intramuscular administration), diprospan is used in an initial dose of 1-2 ml. Further treatment is carried out as needed, depending on the patient's condition.

But most often the drug is administered topically. In such cases, it is often used together with local anesthetics (lidocaine, procaine). Diprospan in the joint is administered in a dose of -2 ml. An approximate calculation of the dose, depending on the size of the joint:

  • large - 1-2 ml;
  • mean -1 ml;
  • small 5 ml.

Typically, the course of treatment is 1-5 injections with an interval of 1 week.

After achieving the desired result, the dose of the drug should be gradually reduced to the minimum effective.

And only after that you can try to cancel it completely. If the pathological symptoms return again, the dose of Diprospan is increased.

As a rule, to eliminate acute pain, 1-4 injections of Diprospan

Side effects and contraindications

Diprospan, like any other glucocorticoid, has many side effects and contraindications to use.

The main side effects are:

  • violation of metabolic processes in the body (increased sodium concentration, decreased potassium, obesity, development of alkalosis and lipomatosis);
  • provoking the development of heart failure and increasing blood pressure;
  • weakness of muscles and loss of their mass, development of osteoporosis, provocation of broken bones and tendon ruptures;
  • development of gastritis and peptic ulcer of the gastrointestinal tract, gastrointestinal bleeding;
  • activation of latent infection, development of candidiasis, suppression of immunity;
  • development of steroid acne, stretch marks on the skin;
  • increased pressure inside the skull, convulsions, headache, dizziness, insomnia;
  • violation of the menstrual cycle in women, secondary adrenal insufficiency, steroid diabetes, Isenko-Cushing syndrome;
  • provocation of cataract, glaucoma, exophthalmos;
  • allergic reactions, up to anaphylactic shock.

The incidence of adverse events, as well as the degree of their severity, depends on the method of administration of the drug and duration. As a rule, all side effects are well eliminated by reducing the dose of the drug.

These stretch marks can be a side effect of the prolonged use of Diprospan

Introduction Diprospan is contraindicated:

  • with systemic mycosis lesions;
  • for in / in and / / application;
  • for injections inside the joint with infectious arthritis, instability of the joint, associated with the pathology of the ligament apparatus;
  • with a skin infection at the injection site;
  • in children up to 3 years;
  • with hypersensitivity to this drug or other glucocorticoids;
  • if there are systemic parasitic and infectious diseases;
  • with the state of immunodeficiency;
  • in the period after vaccination;
  • with diseases of the liver;
  • with arterial hypertension, severe heart failure;
  • at a diabetes, a thyrotoxicosis, illness or disease Itenko-Kushinga;
  • with kidney failure;
  • with osteoporosis.

Application during pregnancy and lactation

To date, there is no evidence of possible risks to the fetus when using the mother of the drug Diprospan, since no studies have been conducted.

Taking this into consideration, such treatment is contraindicated and can be used in exceptional cases when the benefit to the mother exceeds the risk for her unborn child.

If there is a need for the use of Diprospan injections in nursing mothers, then the issue of transition on artificial feeding, since the penetration of the drug into breast milk and its negative impact on the baby is not was studied.

Pregnant women use Diprospans contraindicated

Overdose

As a rule, exceeding the dose of the drug does not lead to conditions that threaten life. If very high doses are used in diabetes, glaucoma, acute peptic ulcer disease, conditions that require emergency care can develop.

Terms of sale

Diprospan belongs to the group of prescription drugs and is released from the pharmacy strictly according to the doctor's prescription.

Price and analogy

We advise you to read:How do they blockade the spine with Diprospan?

The average price for injections of Diprospan for one ampoule varies between 325-400 rubles, for a package of 5 ampoules - 1000-1200 rubles.

Analogs of Diprospan:

  • Betaspan Depot,
  • Depos,
  • Flosteron,
  • Betamethasone-Norton,
  • Betaspan,
  • Soderm,
  • Celeston.

Reviews about nyxes Diprospan

Lyudmila, 25 years old: "My father has been suffering from rheumatoid arthritis for 25 years. Despite the basic therapy, it is very hard for the constant pain in the ankles and elbows.

The attending physician ordered him to do injections of diprospan into the joints. Do 1 injection in each painful joint once every 3 weeks.

The state of health has significantly improved, the pain has practically passed. "

Nina Ivanovna, 62 years old: "I suffer from arthrosis of knee joints for 10 years. Problems began with the onset of menopause. I tried various painkillers and anti-inflammatory drugs, but the pain still did not leave. I had to start walking with a cane.

My friend advised me to try Dikspapan intra-articular injections. Relief noted after only 1 injection, after 3 pain and completely gone. On this I stopped treatment, but, unfortunately, the pain returned again after 2 months.

Conclusion: the medicine is excellent, but only the effect is short-term. "

Oleg, 40 years old: "In view of my professional activity, I have been suffering from osteochondrosis of the lumbar spine since my youth. Pain constant, analgesics and NSAIDs eliminate pain syndrome for only a few hours.

The doctor advised to make a blockade of the spine with anesthetics and Diprospan. Immediately after the first injection, the pain significantly decreased, began to move more freely. The full course of treatment was 4 injections. It's been 2 months now, and the pain does not come back.

True, he began to engage in physical therapy because the injections are too expensive. "

Making a conclusion, it should be noted that Diprospan is an excellent assistant in the fight against acute pain syndrome and inflammation, especially in case of pathology of the musculoskeletal system. But do not forget that this is only a symptomatic remedy.

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Although it removes acute symptoms, it often fails to eliminate the true cause of pain. Therefore, such therapy should be prescribed only in emergency cases and never replace therapeutic exercise and other basic medical measures.

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A source: http://MoyaSpina.ru/medikamenty/ukoly-diprospan-sustavov

What is the blockade of the knee joint (shoulder, elbow, hip): treatment with injections of drugs (Diprospan)

Blockade of the knee joint (an injection in the knee) is necessary to stop the manifestations of the inflammatory process and degenerative-dystrophic lesions of the joint, soft tissues and ligaments.

The procedure involves the introduction of medications locally, which helps to get immediate results due to the effect directly on the site of inflammation and the focus of pathology.

Blockade of the joint has been used for many years in domestic and world medical practice. A similar procedure is performed by surgeons, orthopedists, rheumatologists and traumatologists.

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Doctors believe that injections and the introduction of medicines into the area of ​​the affected wrist, ankle joint or periarticular tissue for a long time will be able to block pain, and promotes a gradual regression of the disease. This fact is confirmed by the patients' feedback.

How does the treatment work?

A drug administered periarticularly (intraarticular injection into the knee joint) is necessary at the earliest stages of the inflammatory process and degeneration. And it is important to produce a blockade regardless of the syndrome of the disease and its causes.

Blockade of the knee joint is a method of treatment that involves suppressing infection by introducing antimicrobial drugs.

If the patient suffers from arthritis or arthrosis, then, as a rule, antimicrobial therapy will include the use of:

  • antibiotics;
  • antiseptics.

Sometimes, drainage of the diseased knee or wrist joint can be prescribed.

The most powerful drug, with the help of which the procedure is performed, currently glucocorticosteroids. They are characterized by an anti-inflammatory effect and a sufficiently strong immunomodulating activity for arthrosis.

Only such a preparation can help in getting rid of arthrosis of the knee, wrist joint or its tumor.

Preparations for blockade

Local injections of blockade can be performed with the help of special preparations with a narrow spectrum of action.

With equal effectiveness, such means can be used to blockade the shoulder joint and block the hip joint.

As a rule, doctors make a shot with medicines (they only have positive reviews):

  • hydrocortisone acetate. The drug is produced in 5 ml vials containing 125 mg of active ingredient hydrocortisone acetate. The advantage of the drug is that it can not leave the joint cavity and therefore the effect of the application lasts no less than 7 days. Hydrocortisone can be prescribed for mild manifestations of the disease and for removal of infiltrate from periarticular tissues;
  • diprospan. This drug is one of the forms of betamethasone. It has a different name, fluorinated methylprednisolone. One ampoule (1 ml) contains 5 mg of betamethasone dipropionate and 2 mg of betamethasone disodium phosphate. Such a rapidly dissolving ether is perfectly absorbed and helps to minimize the pain. And the effect of the injection diprospan prolonged;
  • Kenalog-40. The drug is available in the form of a suspension based on fluorinated glucocorticoid. Kenalog-40 can be purchased in vials of 5 or 1 ml in a solution concentration for injections of 40 percent. The result is achieved after a day and can last for about a month. However, you should know that the drug has a significant side effect - skin atrophy, necrosis of muscle tissue, tendons and subcutaneous fat.

Treatment will help with arthrosis of the ankle and wrist joint. The injection with diprospan starts working after 3 hours after the injection. The result of therapy lasts up to 30 days and this is confirmed by numerous reviews.

It should be noted that with the introduction of medicines, absolutely no painful sensations and complications should arise. Therefore, manipulation can be performed without the use of anesthetics.

If the patient feels pain, this is evidence of an incorrect procedure for arthrosis (more details will be given by the reviews).

Despite the fact that the injection with diprospan is a powerful effect of the glucocorticosteroid on the body, the remedy is completely safe and practically has no restrictions in the application.

The drug is characterized by a bright anti-inflammatory effect. Blockade of the knee joint with this tool can be used even in quite severe cases, for example, in case of lupus erythematosus. It is always very important to choose an adequate dosage. Often the injection is done with 1 ml of medication.

Indications for the procedure

Blockade of the knee joint is necessary for patients with such diseases:

  1. reactive synovitis (stages of the disease that occur against arthrosis of articular surfaces);
  2. arthritis of non-infectious nature (reactive, psoriatic, rheumatoid, acute microcrystalline arthritis, Reiter's and Bekhterev's disease);
  3. postoperative serous, post-traumatic arthritis;
  4. ganglia, bursitis, tendovaginitis, periarthritis.

When blockade is prohibited

It is not always possible to show a blockade and a drug inside the joint. This restriction applies to diseases:

  • deforming osteoarthritis (it is possible to produce only a periarticular prick with diprospan);
  • arthritis in the chronicle (with pronounced destruction);
  • zero effect of 2-3 injections at the same knee site.

How does blockade occur?

In domestic medicine apply two options for blockade of the joints (knee, wrist and ankle). The injection can be done either from the outside or from the inside. Sometimes a doctor can perform blockade immediately on both sides.

As a rule, blockade of the knee joint is performed from the outside. Such a method is considered relatively simple and safe.

Sticking the drug from both sides is necessary in especially severe and serious cases of the disease, when it is necessary to quit the pain syndrome as soon as possible, for example, after a puncture or operation on the joint.

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If an injection is made from the outside, the patient should lie on his back and place a soft cushion under his knee. In this case, the syringe needle penetrates to the border of the upper part of the nadal region (behind its third part).

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Then, the doctor gradually moves the needle parallel to the back of the knee joint. Introduce up to 15 ml of the medicinal mixture (excluding drugs with steroids).

In each specific case, the dose of the administered substance will be different and depends on:

  • age;
  • weight;
  • diagnosis of the patient.

If arthrosis gives unbearable pain, then to eliminate them may require the use of anesthetic, chondroprotector, B vitamins and homeopathic remedies.

A source: http://sustav.info/lechim/medikamenty/blokada-kolennogo-sustava.html

Knee joint: blockade with diprospan, side effects of the substance

To date, joint blockade is widely used to treat rheumatological diseases, such as arthritis, arthrosis, reactive synovitis.

The procedure is becoming more popular, however, most patients do not know well what blockade of joints is.

Directly into the articular cavity, the synovial bag or the surrounding periarticular tissues, a medicinal preparation (Diprospan, Hydrocortisone, Novocaine), with the aim of removing the inflammatory process, eliminating pain and improving mobility joints.

Blockade of knee joint with diprospan

With the help of diprospan, a blockade of the hip, shoulder and knee joints is performed with arthroses, arthritis and other diseases.

The procedure is carried out exclusively by a specialist, using special equipment in conditions of maximum sterility.

In this article the conversation will go about blocking the knee joint with the help of the drug Diprospan.

Diprospan Preparation

The drug name of the drug is Diprospan. The active substance is - betamethasone.

The drug belongs to the pharmacological groupGlucocorticoids, based on hormonal agents. Diprospan is produced in the form of a suspension and solution for injection.

The solution is realized in ampoules of 1 ml. The suspension is packaged in syringes or ampoules with a volume of 1 ml.

In the pharmacy is released individually or 5 ampoules in a cardboard box.

In one milligram of the suspension or solution, 5 mg of betamethasone dipropionate (corresponding to 5 mg betamethasone) and, mg betamethasone sodium phosphate (2 mg betamethasone in equivalent) are contained.

Excipients: benzyl alcohol, water for injection, phosphate, sodium chloride, Trilon B, polysorbate 80, polyethylene glycol 4000, anhydrous sodium phosphate.

Like all glucocorticosteroids, the solution looks like a clear, colorless, viscous liquid, in which it contains a small amount of white particles.

After shaking, the liquid becomes homogeneous, white. Diprospan has a pronounced glucocorticoid activity. The effect of mineralocorticoids is not pronounced.

The drug is aimed at suppressing immunosuspension, inflammation, allergic reaction.

The medicine consists of several components that have different speed of action. The first: betamethasone sodium phosphate, quickly dissolves and absorbed into the body, hydrolyzes and provides a quick healing effect.

Excreted within 24 hours. The second: betamethasone dipropionate, creates a depot after administration, from which it is gradually released, resulting in a long-lasting analgesic effect.

The time of excretion from the body is about 10 days.

The drug Diprospan differs crystals of very small size, which allows it to be used in small joints using a very thin needle.

Application of the drug

Diprospan is widely used to block any large joint.

The drug is considered one of the most powerful among anti-inflammatory drugs, and resort to it when other drugs are ineffective.

During application, Diproppan proved to be one of the most effective and has many advantages:

Equally effectiveas when injected into the periarticular tissues, and when injected into the joint cavity.

Two forms of active substance contained in the composition, are able to realize the therapeutic and therapeutic effect both slowly and quickly.

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In other words, the injection starts to act after a few hours and remains active for 3 months.

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With a small inflammatory process will cope with a single injection. The drug does not cause allergies and addictive, so if necessary, there is the possibility of a second injection.

Low price and long-term therapeutic effect make the medicine one of the most popular for most patients with arthrosis and arthritis in chronic form.

Indications for blockade

The magnitude of the pathological condition or the application of the therapeutic method directly affects the outcome and effectiveness of the procedure.

Introduction diprospana without the presence of inflammation insidejoint, synovial bag or periarticular tissue, loses all meaning.

Diseases in which the procedure is shown:

  • Psoriatic, non-infectious, rheumatoid arthritis.
  • Arisen after arthritis or surgery.
  • Inflammatory processes of the bursa or periarticular tissues (for example, tendovaginitis, periarthritis, bursitis).
  • Osteoarthritis. Only with symptoms of inflammation of the synovium or joint. If signs of inflammation are not pronounced, application of the procedure is possible in cases when other methods of treatment do not help or can not be performed.

However, even in cases where there are serious indications for the procedure,should take into account some of the nuances:

  • Infection should not be the cause of the inflammatory process. In this case, blockade of the knee joint with the help of diprospan can aggravate the situation, and also complicate the course of the disease.
  • Simultaneous introduction of diprospan into several affected joints is immediately undesirable.
  • First, the procedure is carried out for those joints that play a vital role for the patient.
  • Self-administration of the drug is prohibited. Only a specialist knows how and when to properly blockade the knee joint.

Contraindications for blockade

When injected with diprospan, as in most medical methods, there are relative and absolute contraindications.

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There are diseases and pathological conditions in which intraarticular injection is categorically is prohibited because of the likelihood of complications (in this case, the risk of complications is much greater than the desired result). Among these there are:

  • Presence of a common or local infection.
  • The pathology of bleeding, which was triggered by the intake of medications (eg, anticoagulants) or certain diseases.
  • Absence of a strong joint in the joint, which is associated with weakness of the tendon apparatus.
  • Heavy forms of arthrosis, with pronounced violations of functions and forms in the joints.
  • Osteoporosis. Presence of necrosis sites in the part of the bone (necrotic changes).
  • The general severe condition of the patient, not related to the infectious process.
  • Pathological or chronic disorders of the liver and kidneys.
  • Inefficiency of 2-3 previous injections.

With mild and relative contraindications, there is often a curative effect. When it happens that the possible use of the injection significantly exceeds the estimated risk, the attending physician may disregard the restrictions for using diprospan.

Conducting the procedure of blockade

Prior to the commencement of the procedure,the specialist must determine the dosage of the drug administered. For each patient, the doctor individually selects a dose.

In the case of blockade of the knee joint with arthrosis or arthritis, the amount of substance can be 4-6 ml, depending on the sensitivity of patients.

The drug is bred with novocaine or lidocaine.

The procedure must necessarily be performed by a specialist doctor, usually an orthopedist or surgeon.

In some cases (for example, with edema of the knee, phobia of the patient to injections), a specialist can apply local anesthesia.

The area of ​​needle insertion is abundantly lubricated with iodine solution and a puncture is planned in a specialist of the near-articular region, where the drug is then administered.

It is worth noting that the medicine works almost immediately. Within half an hour, the patient's mobility improves, and pain is also relieved. Further, the puffiness decreases, the pain sensations disappear along with the reddening of the surrounding soft tissues.

Many patients suffering from arthrosis or arthritis do not know how the blockade is performed. Studies, as well as clinical trials have shown that this procedure is performed more often than similar methods of treatment.

The blockade algorithm is very simple: the patient is laid on the couch, a roller is placed under the knees to fix the leg in a semi-bent and relaxed state.

Often, the place of the planned injection is cheated with novocaine or lidocaine, that is, resort to local anesthesia.

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The puncture site is pretreated with iodine or alcohol. For the introduction of the drug, there are several points in the knee joint. Most often, this point is the outer edge of the patella.

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The specialist punctures the skin and connective tissues right up to the joint, then a special syringe is inserted into the hole, with the help of which the blood, pus, exudate is pumped out.

After the end of purging synovial bags, a drug is administered, the volume of which can be from 2 to 10 ml, depending on the severity of the disease.

After completion of the procedure, the patient is in the health department for several hours. At this time, the doctor must monitor the effectiveness of the drug.

The first 3-4 hours after the operation, the joint needs complete rest. For this you can use special orthopedic corsages for immobilization, although this is not necessary.

It is enough for a patient to rest easy and not to make sudden movements.

On the day of the joint block surgery, the patient should refrain from massage, physiotherapy procedures and visits to exercise therapy. From the next day, the therapeutic course should be resumed according to the old scheme. Sharply increase the load on the joint, despite some improvements, is strictly prohibited.

Often patients ask the doctor for an increase in the frequency of administration or dosage. This happens because the desired result does not appear immediately.

However, it is worth remembering that glucocorticosteroids are not simultaneously injected into several large joints. There are specific limitations on the use of drugs and intra-articular suspension.

There are basic rules for the reception and use of glucocorticoids: drugs are not found more than 3 times a year; break should be 12-15 weeks between injections.

Complications after surgery

Recently, the number of complications after blockade of the elbow, shoulder, knee, hip and Other joints have sharply decreased due to the level of equipment with equipment and the growth of professionalism health workers.

The following types of complications after the blockadeknee joint are possible, although extremely rare:

  • Infection of the periarticular tissues or joint (infection of the infection).
  • Due to the incorrect insertion of the needle, it is possible to increase the inflammatory process and pain.
  • Violation of the general condition of the body (vomiting, nausea, pressure jumps may increase).
  • Violation of the multiplicity and dosage during the procedure, can lead to the progression of degenerative and dystrophic changes.

Forecast

The data of clinical statistics suggest that every third patient, regardless of the form of rheumatoid arthrosis, undergoes blockade of the joint with diprospan. More than 95% of patients feel positive after the procedure.

It has been established that blockade helps to shorten the period of joint treatment, and also to accelerate the removal of edema and inflammation in soft tissues in bursitis, synovitis, tenosynovitis, periarthritis.

Important to remember,that the feasibility of a medical blockade with diprospan, only the specialist determines, and the purpose of the therapeutic blockade depends not on your desire, but on the severity and nature of the rheumatological pathology.

A source: https://SkeletOpora.ru/terapii-i-diagnostika-nog/blokada-kolennogo-sustava

Blockade of knee and shoulder joints by diprospan

By "joint blockade" in medicine, we mean injections of anti-inflammatory or anesthetic agents into its cavity or surrounding tissues (intra-articular or near-articular administration).

This method, developed about 50 years ago, is now widely used by doctors who treat diseases of the musculoskeletal system.

It allows you to inject the medicine directly into the lesion, allowing you to increase the effectiveness of treatment and eliminate the side effects of certain medications.

The most commonly used drugs are hormones (glucocorticoids). With this route of administration, they fall directly into the intraarticular fluid and the surrounding synovial membrane.

This provides an immediate anti-inflammatory effect for a long time.

There are practically no side effects of taking hormones due to their lack of blood.

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This drug is a glucocorticoid - an artificially created analogue of the hormone of the adrenal glands. They are the most powerful anti-inflammatory drugs in modern medicine.

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The mechanism of their action in the joints is to prevent the penetration of cells of the immune system through the synovial membrane.

Since they do not get inside, there are no cytokines - special proteins responsible for the development of inflammation.

The main advantages

Diprospan has a number of advantages that allow using it for chronic inflammatory diseases of the joints:

  • Contains two main components that dissolve quickly or slowly. Therefore, it has both a fast (already after 3 hours) and a long-term elimination of inflammation and pain up to two months.
  • It does not form a deposit on the joint capsule, therefore, there is a low risk of allergies.
  • Unlike other glucocorticoids, diprospan does not cause disturbances in nutrition and exhaustion of surrounding tissues.
  • With the same result can be administered both into the cavity and into the periarticular space.
  • To eliminate a small inflammation, a single injection is sufficient.
  • Repeated blockage of the joint is not contraindicated.

Indications for blockade

To observe the effectiveness of the method by 90-95%, as in the scientific literature, it is necessary to take into account the type and nature of the disease. A mandatory component is the presence of acute and active inflammation:

  1. Inside the joint, especially with effusion to the cavity (most often rheumatoid or psoriatic arthritis).
  2. Synovial membrane of the joint (synovitis with gout, arthrosis, trauma).
  3. In periarticular tissues with affection of bags (bursitis), ligaments (entesitis), tendons (tendinitis) or other soft tissues.

With mild inflammation, it is possible to use only if it is impossible to treat by other means, for example, with gastric ulcer or allergies. There are three more criteria that must always be checked, even with clear indications:

  • It is necessary to exclude infection, as the cause of inflammation (the introduction of hormones only aggravate the process).
  • The number of affected joints should be limited.
  • Only those joints that are most significant for life (for example, blockade of the knee joint) are blocked.

Contraindications

Divide into 2 main groups. When absolute - the implementation of blockade diprospan is prohibited, since the occurrence of complications is inevitable.

  1. Infection in the joint, surrounding tissues or common (throughout the body).
  2. Increased bleeding associated with diseases or taking anticoagulant drugs.
  3. Pain and other symptoms are not caused by inflammation (eg, nerve damage).
  4. Late stages of arthrosis, accompanied by a violation of the shape of the joint and mobility in it.
  5. Lack of stability in articulation (chronic trauma of ligaments, dislocations).
  6. Dying (necrosis) of the bone adjacent to the joint or intra-articular fracture.

With relative contraindications, the procedure is not performed, since the likelihood of a lack of therapeutic effect is high. But it can be performed when the doctor or patient aspires to do so, and also after assessing the possible risk.

These include a general severe condition, but not necessarily as a result of infection. It is possible after heart attacks or strokes, serious injuries.

Severe chronic insufficiency of the work of any internal organ also severely limits a person's capabilities.

The latter is the low efficiency (or lack thereof) of at least 2 articular blockades, conducted earlier.

Preparing for the procedure

Blockades are performed only in a hospital or polyclinic. It is necessary to have a special treatment room equipped with equipment and medicines. A mandatory requirement is strict adherence to cleanliness and sterility on the part of both the medical staff and the patient.

  • At home, you need to take a shower and put on clean clothes.
  • If there is hair on the body, it is advisable to shave them on the skin around the joint.
  • It is necessary to take with itself a clean change of clothes (for example, a nightgown and trousers) and shoes.
  • With long hair, a headscarf or a disposable cap will be needed on the head to clean them.
  • During the procedure, it is better not to talk.

Technique of execution

To prevent complications, the health care provider carries out the complete sterility of the procedure. Only disposable instruments (syringes and needles) are used.

Diprospan specifically goes in a dosed form for 1 injection, so as not to leave the ampoule open.

Therefore, for the blockade of different joints, clean tools and drug solutions from different ampoules are used.

Dosage of the drug

All glucocorticoids go in the form of either a concentrate or a dry powder. The ampoule or vial is a single dose, that is, for a single dose. Before the procedure, they are diluted with various solutions from 1 ml for small and up to 5 ml for large joints.

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The amount of medication administered depends on the size of the joint.

  1. If blockage of the knee joint (large) is performed, then one dose is used.
  2. In the middle (ulnar) articulation, only half is introduced.
  3. In small - already a quarter from diluted diprospan.

Blockade of the knee joint

It is used most often in clinical practice. This is predisposed by a typical knee injury in arthritis and arthrosis. Limitation of mobility and the risk for a person to become an invalid leads to a first-order procedure on this joint.

Begin with emotional and medicament preparation of the patient. The doctor explains all possible "painful" moments of the intervention.

Particularly disturbing is the injection of a sedative or local anesthesia (chipping) with novocaine.

It is necessary to take a prone position and relax your leg.

Further, the skin is treated with antiseptics, after which the doctor already chooses a place for puncture in sterile gloves. There are four standard points around the patella, usually choosing the upper-external.

First, take an empty sterile syringe and gently make a puncture (puncture) into the joint cavity.

This is done to remove excess fluid from there, after that the needle is removed and discarded.

Then, taking a syringe with diprospan, similarly pierce soft tissue, enter the cavity and slowly inject the drug.

Blockade of the shoulder joint

Indications for this type of manipulation are inflammation of various ligaments, in a large number of braided braids.

Begin with standard procedures - first give the patient a comfortable position (lying or sitting with a support for the back and hands).

The skin is treated with alcohol and iodine solution three times, after which the doctor puts on sterile gloves and chooses a puncture site.

Points for puncture two: external and anterior. Since the tendon of the biceps is more often injured, the anterior puncture is the method of choice.

Pressing the fingers of the muscle, the doctor "control" needle falls into the joint cavity and removes excess fluid.

Then a new puncture and periarticular tissue is made, or a solution of diprospan is injected inside.

After the blockade

Immediately go home is not recommended, since active movements will lead to absorption of the drug and a decrease in therapeutic effect. It is necessary to create the rest of the limb for at least 3 hours. Special means of immobilization for this is not required, just lie down.

During the next week, despite the improvement in the condition, do not change your activity and protect the joint from overexertion. Useful short-lived (no more than 30 minutes) walks in the fresh air.

Many patients, especially with a weak effect of the drug, try to require frequent blockade. But there are certain requirements for the use of hormones:

  1. First, there is a restriction on the number of procedures conducted. Simultaneously, they can be carried out on one large (blockade of the knee joint) or from 3 to 5 small and medium. In the latter case, different combinations are possible, usually performed on one average and several small ones.
  2. Secondly, it is impossible to inject glucocorticoids into the supporting joints (hip, knee, ankle) more than 3 times a year.
  3. Thirdly, the intervals between blockades must be long-at least 3 months.

Forecast

At present, intra-articular diprospans are administered to every 3 patients with rheumatoid arthritis.

Efforts are being made to create special treatment rooms in polyclinics to perform this procedure.

It has already been proved that the use of local blockades makes it possible to shorten the treatment time for inflammatory joint diseases for up to 10 days.

A source: http://MedOtvet.com/vosstanovlenie-sustavov/blokada-kolennogo-i-plechevogo-sustavov-diprospanom.html

Are Diprospans injected into the joint dangerous?

page »Medications» Are Diprospans injected into the joint?

Diprospan is a glucocorticosteroid, that is, an artificial analogue of the hormones of the adrenal cortex.

The drug has a rapid, pronounced anti-inflammatory, anti-allergic and anti-shock action, is an immunosuppressant (suppresses immunity), affects the metabolic processes in the body.

The drug consists of two components - high-speed and with prolonged action:

  • The first - betamethasone sodium phosphate - for a short time is hydrolyzed and absorbed after administration, dissolving in body fluids and providing an almost immediate effect of treatment. It is also displayed quickly - for 24 hours.
  • The second - betamethasone dipropionate - is excreted from the body only after 10 days and provides a long-term therapeutic effect for several weeks.

The preparation is produced in the form of a suspension in ampoules for injections of 1 ml, packed in 1 or 5 ampoules.Enter Diprospan by any means, except - intravenous and subcutaneous injection!

Indications for use

Given the powerful healing capabilities of Diprospans, it is used to relieve acute conditions in the musculoskeletal apparatus, with allergic, dermatological and autoimmune diseases. Also with diseases of the kidneys, adrenals, blood and digestive tract, and other severe pathologies, when hormonal therapy is needed.

Diprospan (225 rubles)

For the treatment of the joint apparatus, injections with Diprospan are widely used in the following cases:

  • with rheumatoid arthritis (including myositis, bursitis, tenosynovitis, epicondylitis, synovitis);
  • with arthrosis;
  • with gout and psoriasis;
  • post-traumatic osteoarthritis;
  • osteochondrosis and its consequence - a hernia of the spine;
  • torticollis, heel spur, hygroma.

Usually, blockages are performed with the diposcopic knee, elbow or other joints.

Contraindications

With intramuscular introduction and short course of application, sensitivity to the components of the drug is the only absolute contraindication.

When the drug is injected into the joint, contraindications include:

  • infectious arthritis and endocarditis;
  • diabetes mellitus (not blood coagulability);
  • instability of the joints;
  • near the joint infections, all kinds of skin diseases at the injection site.

Also, relative contraindications are: gastric and duodenal ulcer, thrombophlebitis, tuberculosis, renal failure, glaucoma, fungal and bacterial infections, nephritis. It is impossible to carry out vaccination during the course of Diprospan, since no antibodies are produced. The use of children under the age of three is prohibited.

Consequences and side effects

Since this drug belongs to the GCS group, with prolonged, frequent admission in large doses, it can give serious side effects.

  • From the side of the central nervous system: Diprospan can cause increased intracranial and arterial pressure, insomnia, panic and joy attacks, dizziness. In severe cases - there is a psychosis with hallucinations, delirium and loss of sense of reality.
  • From the side of the eyes: the intraocular pressure rises, glaucoma, cataracts may appear. Viral and fungal lesions of the eyes are also possible.
  • From the metabolism and endocrine system: fluid retention in the body, swelling, a set of excess weight, cellulite, acne, menstrual irregularity. Because of the constant suppression of the function of the adrenal cortex, its atrophy occurs, the synthesis of its own hormones decreases, which leads to secondary renal failure. Children - stunting and puberty.
  • From the side of the cardiovascular system: the water-salt balance is broken, at which potassium and calcium are washed away, which leads to weakening of the heart muscle. At the same time, water retention, which leads to swelling of the tissues. Develops heart failure, bradycardia, thrombosis.
  • The digestive system can get complications in the form of pancreatitis, increased flatulence, erosion, and then stomach ulcers.
  • The musculoskeletal system can have such consequences: loss of muscle mass, myopathy. Bones become brittle, which leads to compression fractures of the spine and other spontaneous fractures (osteoporosis). Aseptic necrosis of the hip and shoulder joints, as well as ruptures of ligaments and tendons may occur as a result of suppression of connective tissue growth.
  • Allergic reactions can manifest as angioedema, arterial hypotension, and anaphylactic shock.
  • Local reaction manifests itself in areas of unhealthy pigmentation, atrophy of the skin, purulent abscess.

Side effects from the use of Diprospan can be stopped and even corrected if the dose and frequency of reception are reduced.

However, there may be purely mechanical complications associated with the way the drug is injected into the joint cavity.

This - hemorrhage, sepsis (skidding infection), damage to the tendons or nerve endings of the joint.

Instructions for use

The dose of the drug and the way it is administered depend on the clinic and the severity of the disease.

  1. You can administer the drug intramuscularly - in the treatment of systemic diseases. The initial dose of the drug is usually 1-2 ml of the suspension, it is injected deep into the gluteus muscle. Further appointments depend on the patient's current condition.
  2. Directly into the lesion site, the hormone is injected into the heel spur syndrome and skin diseases, in amounts, ml per injection, so that the weekly norm does not exceed 1 ml.
  3. The intraarticular and periarticular (inside the synovial joint of the joint) introduction is called a blockade. The blockade is used to relieve acute pain syndrome and restore mobility of joints in diseases of the musculoskeletal system.

Typically, blockade is done with the addition of an anesthetic (lidocaine) or a syringe with a hormone, or at first separately anesthetize the injection site.

Pain in degenerative inflammatory diseases of the musculoskeletal system is removed by a dose of up to 2 ml of the suspension, the exact dosage depending on the joint size:

  • in small - phalanx, clavic and carpal - prick, 5 ml;
  • for blockade of middle joints - elbow, shoulder, ankle and nyxes in the knee - use, ml or 1 ml;
  • in the hip and in the joints of the spine with a hernia - one injection of 1-2 ml of the drug is allowed.

Between each injection should take at least 7 days. The courses of treatment with Diprospan injections - up to three per year. The number of blockades is determined by a specialist in the condition of the patient.

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"Blockade of pain in the neck by Diprospan"

How is the blockade carried out in practice, is it dangerous, and whether to be afraid - look in our video.

Do you have any questions? Specialists and readers of the site Portal about the joints of a person will help you, ask a question

A source: https://prospinu.com/medikamenty/diprospan-ukoly-v-sustav-posledstvija.html

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